Challenges, Innovations, and Next Steps in Achieving Financial Neutrality for Living Donors
Challenges, Innovations, and Next Steps in Achieving Financial Neutrality for Living Donors
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DOI：
10.1007/s40472-020-00291-1
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发表时间：
2020-09-01
影响因子：
2.1
通讯作者：
Sutha, Ken
中科院分区：
文献类型：
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作者：
Mittelman, Michael;Bertha, Rebecca;Sutha, Ken
最近，国家对活体肾脏捐献的关注使人们重新关注减轻捐献者经济负担、减少捐献过程中的自付费用以及优化后续护理的相关政策。本综述研究了推进美国肾脏健康行政命令及其改善活体器官捐赠者财务中立性的潜力。包括单中心和多中心研究在内的现有研究表明，活体捐赠者在捐赠过程中面临经济负担，这可能会通过支付与受抚养人护理相关的工资和费用损失而减少。根据这些发现，最近的共识声明和随后的联邦指导建议采取干预措施，以减少活体捐赠者的财务障碍。改善活体捐赠者财务中立性的政策努力有助于消除捐赠的抑制因素，并促进更多的活体捐赠者移植。应监测政策变化的结果，以确定影响，并确定进一步的关注领域，包括提高偿还上限和放宽捐助者和受援者的收入限制。
Purpose of Review Recent national attention on living kidney donation brings renewed focus on policy related to alleviating financial burdens for donors, reducing out-of-pocket expenses incurred in the donation process, and optimizing follow-up care. This review examines the Advancing American Kidney Health Executive Order and its potential to improve financial neutrality for living organ donors. Recent Findings Available research, including single and multi-center studies, demonstrate that living donors face financial burdens in the donation process, which may be decreased by covering lost wages and expenses related to dependent care. Drawing from these findings, recent consensus statements and subsequent federal guidance proposed interventions to reduce financial barriers for living donors. Policy efforts to improve financial neutrality for living donors can help remove disincentives to donation and facilitate more living donor transplantations. The outcome of policy changes should be monitored to determine impact and identify further areas of attention, including increasing reimbursement caps and liberalizing donor and recipient income limits.